This content is excerpted from EyeNet’s MIPS 2021; also see the Academy’s MIPS hub page.
Check your status. Use the QPP Participation Status tool, where you can enter your 10-digit National Provider Identifier (NPI) to find out:
- if you are eligible to participate in MIPS;
- if any exclusions apply to you (and if so, whether you can opt in to MIPS); and
- if a special status—such as being in a small or rural practice—applies to you.
MIPS tip. If you are in multiple practices, make sure you scroll all the way down to check your status at each practice.
Preliminary eligibility information published in late 2020. CMS uses two 12-month time segments (see “MIPS Determination Period”) to assess clinicians’ MIPS status. Starting in late 2020, you could use the QPP Participation Status tool to see your preliminary eligibility information, based on data from the first time segment (Oct. 1, 2019-Sept. 30, 2020).
Final eligibility information published in November 2021. CMS will reconcile data from the second time segment (Oct. 1, 2020-Sept. 30, 2021) and will then update the Lookup tool with your final eligibility information. If you qualify for an exclusion based on data from one time segment, you will be exempt—even if you don’t qualify for the exclusion in the other time segment.
Use the QPP Participation Status tool to check your quarterly snapshots. During the determination period’s second time segment (Oct. 1, 2020 –Sept. 30, 2021), CMS will provide you with quarterly snapshots that will show—based on the data available at that point in time—what the agency’s provisional status and eligibility determinations would be for you. Although the final determinations won’t be made until after Sept. 30, 2021, these informational snapshots will give you a sense of what those final decisions are likely to be.
MIPS Determination Period
The MIPS determination period is a 24-month assessment period. It consists of two time segments; for the 2021 performance year, these are as follows:
- Oct. 1, 2019–Sept. 30, 2020 (with 30-day claims run out)
- Oct. 1, 2020–Sept. 30, 2021 (no claims run out)
Why the MIPS determination period matters. CMS uses data from these two time segments to determine whether clinicians fall under any of the low-volume thresholds and to see whether a practice should be assigned a special status, such as small practice or rural practice.
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